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Therapeutic alloplastic laser in situ keratomileusis for myopia
A Maldonado-Bas1, R Pulido-Garcia
1Department of Ophthalmology, National University of Córdoba, Argentina.
Background:
A new technique, therapeutic alloplastic laser in situ keratomileusis to correct high myopia, is introduced.
Methods:
Therapeutic alloplastic laser in situ keratomileusis consists of neutral homoplastic epikeratoplasty combined with superficial keratectomy performed with an excimer laser and/or a microkeratome. Indications for the technique are: myopia over 20 diopters (D), eyes with corneal scarring after photorefractive keratectomy (PRK), complications following keratomileusis, radial keratotomy complications with undercorrection, and keratoconus suspect myopic eyes.
Results:
In all five eyes we achieved precise corneal lathing with the microkeratome or the excimer laser, and obtained a clear allograft. In all eyes, we maintained or improved the patient's spectacle-corrected visual acuity related to baseline values. We did not induce astigmatism, and corneal thickness was almost unchanged.
Conclusions:
Advantages of therapeutic alloplastic laser in situ keratomileusis are that it provides a Bowman's layer for the cornea following keratectomy, it is possible to lathe ablation diameters larger than 5 mm, it prevents the appearance of corneal haze, and reduces the need for corticosteroid treatment.
